One of the biggest problems that people with bipolar disorder and their families face is “dealing with” the behavior that can sometimes come with bipolar disorder. Friends and families have a hard time accepting that our behavior can be out of our control. That’s understandable. They have never experienced bipolar disorder and don’t know what it’s like inside our heads and our bodies. At the same time, it’s important not to use our disorder as a crutch or an excuse. We have to know if our behavior is due to our disorder or just our personalities. Basically, is your bad attitude due to your symptoms or are you just a jerk?
We all know what personality traits are. Everyone has them. The intelligent people over at the Massachusetts Institute of Technology came up with a few hundred of them. You can be adventurous, idealistic, witty or kind. On the other hand you can also be selfish, deceitful, lazy, pedantic or unreliable. Your traits come together to make up who “you” are.
So how do we decide when these traits are a disorder?
Unfortunately it’s not an easy process. There is not yet a yes/no biological definition between what constitutes as “normal” and a disorder. The more we study genetics and brain structure the easier it will be to say definitively whether or not a person has bipolar disorder, but right now we pretty much rely on psychiatry.
Psychiatry is generally subjective. It largely depends on how you describe your symptoms and circumstances and how a medical professional interprets that information. Medical professionals spot the nuances in personality in addition to the mood cycles and any physical symptoms. Then you get your diagnosis.
As far as personality traits figuring into the diagnosis, it works on a bell curve or a spectrum. The majority in the center is considered “normal.” It’s when the intensity of the personality trait starts heading toward either end of the spectrum where it comes into suspect of being part of a disorder. Again, it’s a matter of interpretation.
Are you inactive and lazy or is it depression? Are you hyper and outgoing or is it mania?
Since there is no line, we have to make a judgement call. It’s possible that you are lazy by nature, but it’s exacerbated by depression. It’s also possible that you’re not lazy, but the sadness and loss of interest during depression can be mistaken for laziness by those who aren’t familiar with it.
When you’re in the thick of an episode, it can be especially hard to distinguish. People with bipolar disorder can have a hard time recognizing they are having mood change. This happens more often in mania than depression since mania can involve more positive feelings.
This is why it’s important for patients to track their moods regularly, not just when they’re symptomatic. Friends and family can also be on the lookout, but please do not use our behavior as a weapon against us. If you are going to point out behavior changes, especially negative ones, we need you to do it as objectively as possible and without derision. People don’t respond well if they’re feeling attacked.
There are personality traits that are more common in people with bipolar disorder that aren’t necessarily related to symptoms.
They’re not descriptions like narcissistic, depressed or irritable that only show up during episodes. These are traits that are always present, and it just so happens that we tend to have more in common than the items on the checklist used to give us the diagnosis. Here are a few examples:
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